Continuous Transversus Abdominis Plane Block After Laparoscopic Sleeve Gastrectomy in 50 Consecutive Cases

Area of Science:

• Bariatric Surgery
• Pain Management
• Regional Anesthesia

Background:

• Enhanced recovery after bariatric surgery is crucial for reducing complications and improving patient outcomes.
• Ultrasound-guided transversus abdominis plane (TAP) block is a regional anesthesia technique known to alleviate postoperative pain and decrease opioid requirements.
• Investigating continuous TAP block efficacy in laparoscopic sleeve gastrectomy (LSG) can optimize postoperative care.

Purpose of the Study:

• To evaluate the effectiveness of continuous ultrasound-guided TAP block in patients undergoing LSG.
• To compare postoperative pain scores, opioid consumption, and antiemetic requirements between patients receiving continuous TAP block and those who did not.
• To assess the safety and feasibility of continuous TAP block in the context of LSG.

Main Methods:

• Fifty consecutive LSG cases utilized ultrasound-guided TAP blocks, with data compared to 157 historical LSG cases.
• TAP blocks were performed using ultrasound guidance, identifying the transversus abdominis plane for catheter insertion.
• 0.5% bupivacaine was administered via elastomeric pumps connected to the TAP catheters.

Main Results:

• While no significant differences were observed in patient demographics or hospital stay, the TAP block group showed a reduced need for opioid injections within 24 hours (20% vs. 36.82%).
• The TAP group also had a significantly lower requirement for ramosetron (antiemetic) injection within 24 hours (0% vs. 9.45%).
• Two cases experienced minor complications related to catheter removal, requiring local anesthesia.

Conclusions:

• Continuous TAP block effectively reduced the need for additional opioid and antiemetic medications within the first 24 hours post-LSG.
• Although cumulative opioid consumption was not significantly reduced, the targeted reduction in immediate postoperative medication needs is clinically relevant.
• Continuous TAP block is a viable adjunct for pain management in LSG, contributing to enhanced recovery protocols.